Vertebral Artery Variations at the Craniovertebral Junction in “Sandwich” Atlantoaxial Dislocation Patients

Yinglun Tian; Nanfang Xu; Ming Yan; Jinguo Chen; Kan-Lin Hung; Xiangyu Hou; Shenglin Wang; Weishi Li

doi:10.14245/ns.2142726.363

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자료유형: 학술저널

저자정보: Yinglun Tian (Department of Orthopaedics Peking University Third Hospital) Nanfang Xu (Department of Orthopaedics Peking University Third Hospital) Ming Yan (Department of Orthopaedics Peking University Third Hospital) Jinguo Chen (Department of Orthopaedics Peking University Third Hospital) Kan-Lin Hung (Department of Orthopaedics Peking University Third Hospital) Xiangyu Hou (Department of Orthopaedics Peking University Third Hospital) Shenglin Wang (Department of Orthopaedics Peking University Third Hospital) Weishi Li (Department of Orthopaedics Peking University Third Hospital)

저널정보: 대한척추신경외과학회 Neurospine Neurospine 제18권 제4호

발행연도: 2021.12

수록면: 770 - 777 (8page)

DOI: 10.14245/ns.2142726.363

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Objective: To summarize the vertebral artery (VA) pattern of 96 “sandwich” atlantoaxial dislocation (AAD) patients and to describe the strategies of reducing the injury of VA during surgery. Methods: From 2009 to 2020, we retrospectively reviewed the 3-dimensional computed tomography angiography data of 96 AAD patients combined with atlas occipitalization and C2?3 fusion, which were diagnosed as “sandwich” AAD and 96 patients as control group patients who were without atlas occipitalization, C2?3 fusion and any other cervical bone deformity at our institution. The variations of each side of VA were described in 3 different parts (C0?1, C1?2, and C2?3) according to the characteristics of the 3-part pathological structures in “sandwich” subgroup. Results: One hundred ninety-two sides of VAs in every group of patients were analyzed and every VA was described separately at 3 different level regions. There were different variations in these 3 different regions: 4 variations in the upper fusion region, 5 variations in the sandwiched region, and 6 variations in the lower fusion region in sandwich AAD patients. And the rate of VA deformity in sandwich AAD patients was much higher and more types of VA variations existed. Conclusion: In “sandwich” AAD patients, deformities of vertebral arteries in craniovertebral junction are more common, and the same VA may have deformities at different levels that severely affect surgical procedures. Therefore, preoperative imaging examination of VA for “sandwich” AAD patients is vital of guiding surgeons to avoid injury of VA during surgery.

#Sandwich atlantoaxial dislocation #Vertebral artery variations #Craniovertebral junction #Atlantoaxial dislocation #Craniovertebral fixation

참고문헌 (20)

참고문헌 신청

Burke JP / 2005 / Iatrogenic vertebral artery injury during anterior cervical spine surgery / Spine J 5:508~514

Garcia Alzamora M / 2005 / Life-threatening bleeding from a vertebral artery pseudoaneurysm after anterior cervical spine approach : endovascular repair by a triple stent-in-stent method. Case report / Neuroradiology 47:282~286

Smith MD / 1993 / Vertebral artery injury during anterior decompression of the cervical spine. A retrospective review of ten patients / J Bone Joint Surg Br 75:410~415

Tumialan LM / 2004 / Tortuous vertebral artery injury complicating anterior cervical spinal fusion in a symptomatic rheumatoid cervical spine / Spine 29:E343~E348

Wang S / 2021 / Anatomical variations of the vertebral artery : analysis by three-dimensional computed tomography angiography in Chinese POPULATion / Orthop Surg 13:1556~1562

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